Department of Neuroscience and Experimental Therapeutics, Albany Medical College, NY, USA.
Nuvasive Clinical Services, San Diego, CA, USA.
Clin Neurophysiol. 2020 Aug;131(8):1731-1740. doi: 10.1016/j.clinph.2020.03.040. Epub 2020 May 7.
To investigate the differences in neural patterns between spinal cord stimulation (SCS) waveforms (60-Hz tonic vs 10-KHz high frequency stimulation, HFS) and their correlation to stimulation-induced pain relief.
We recorded 10-channel electroencephalogram (EEG) in response to stimulation ON and OFF in 9 chronic pain patients (4 women, 5 men) during SCS surgery and examined the intraoperative spatio-spectral EEG features.
We discovered stronger relative alpha power in the somatosensory region and higher trend in alpha/theta peak power ratio in frontal cortex with HFS. We also observed a shift in peak frequency from theta to alpha rhythms in HFS as compared to baseline and tonic stimulation, where slower theta activity was maintained. Further, a positive correlation was found between changes in Oswestry disability index (ODI) scores (from preoperative to postoperative) and HFS-induced alpha/theta peak power ratio in frontal and somatosensory regions.
Altogether, our findings suggest that dynamic spectral interactions in theta-alpha band and their spatial distributions might be the first intraoperative neural signatures of pain relief induced by HFS in chronic pain.
Examining electrophysiological changes intraoperatively has a potential to elucidate response to SCS therapy prior to device selection, reducing the healthcare expenditures associated with failed implants.
研究脊髓刺激（SCS）波形（60Hz 持续刺激与 10-KHz 高频刺激，HFS）之间的神经模式差异及其与刺激诱导疼痛缓解的相关性。
我们在 9 名慢性疼痛患者（4 名女性，5 名男性）的 SCS 手术中记录了 10 通道脑电图（EEG），并检查了术中的时空频谱 EEG 特征。
我们发现 HFS 时，感觉区域的相对阿尔法功率较强，前额皮质的阿尔法/theta 峰值功率比呈上升趋势。与基线和持续刺激相比，我们还观察到 HFS 中的峰值频率从 theta 转移到 alpha 节律，而较慢的 theta 活动得以维持。此外，术后 Oswestry 残疾指数（ODI）评分的变化（术前至术后）与前额和感觉区域的 HFS 诱导的 alpha/theta 峰值功率比之间存在正相关。
总之，我们的发现表明，theta-alpha 波段的动态频谱相互作用及其空间分布可能是慢性疼痛中 HFS 诱导疼痛缓解的第一个术中神经特征。
术中检查电生理变化有可能在选择设备之前阐明对 SCS 治疗的反应，从而降低与植入失败相关的医疗保健支出。
